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01-07-2019 | Research Article

Outcome and toxicity of intensity-modulated radiotherapy with simultaneous integrated boost in patients with pharyngo-laryngeal cancer

Authors: A. Fondevilla Soler, J. L. López-Guerra, A. García Fernández, M. A. Samaniego Conde, M. J. Belmonte González, J. M. Praena-Fernandez, E. Rivin del Campo, M. Alcaraz, I. Azinovic

Published in: Clinical and Translational Oncology | Issue 7/2019

Abstract

Purpose

The present work aims at evaluating intensity-modulated radiation therapy with simultaneous integrated boost (IMRT-SIB) in squamous cell carcinomas (SCC) of the larynx and hypopharynx.

Methods/patients

We performed a single institutional retrospective analysis on 116 pharyngo (29%)-laryngeal (71%) SCC patients (93% male) treated with IMRT-SIB to 66–69.96 Gy in 33 fractions between 2008 and 2016. Those who underwent surgery (54%) received adjuvant radiation of 66 Gy at 2 Gy/fraction to the surgical bed. 16 patients (14%) were treated for a local recurrence after prior surgery. High-risk lymph node regions received 59.4 Gy at 1.8 Gy/fraction and low risk regions 54.12 Gy at 1.64 Gy/fraction. The median age was 60 years and 95% of patients had an ECOG performance status 0–2. Most had advanced stage disease (III 22%, IV 74%). Chemotherapy was delivered in 74% of cases.

Results

Median follow-up was 32 months. Two and three-year overall survival for all patients was 87% and 82%, respectively. There were 28 (24%) locoregional recurrences and 19 (16%) distant failures. Grade 3 mucositis, dermatitis, and xerostomy were observed in 12%, 10%, and 3%, respectively. A longer IMRT-SIB overall treatment time was associated with a higher risk of mortality (HR 1.09, CI 1.01–1.17, P = 0.02). Postoperative IMRT-SIB associated with a significantly lower risk of any recurrence (HR 0.34, CI 0.18–0.64, P = 0.001) and higher local control (HR 0.06, CI 0.01–0.24, P < 0.01). Additionally, it associated with a lower risk of mucositis (P = 0.029) compared with definitive radio (chemo) therapy.

Conclusions

IMRT-SIB is a safe and feasible radiation treatment technique for pharyngo-laryngeal SCC patients with a tolerable acute toxicity profile.

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Title: Outcome and toxicity of intensity-modulated radiotherapy with simultaneous integrated boost in patients with pharyngo-laryngeal cancer
Authors: A. Fondevilla Soler
J. L. López-Guerra
A. García Fernández
M. A. Samaniego Conde
M. J. Belmonte González
J. M. Praena-Fernandez
E. Rivin del Campo
M. Alcaraz
I. Azinovic
Publication date: 01-07-2019
Publisher: Springer International Publishing
Published in: Clinical and Translational Oncology / Issue 7/2019
Print ISSN: 1699-048X
Electronic ISSN: 1699-3055
DOI: https://doi.org/10.1007/s12094-018-1995-0

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